In the Basic delivery model, TA coaches will provide an orientation to Go NAPSACC and its online tools to the center director. The director will then work 2 cycles of Go NAPSACC over 12 months. During each cycle (6 months), centers will take self-assessments on nutrition and physical activity, choose 6 goals (3 from each), create action plans, and take action to achieve their chosen goals. Throughout this 12-month period, TA coaches will provide monthly brief check-ins.

Number of Go NAPSACC core program components completed was captured by the Go NAPSACC website and extracted using the Detailed Activity Report. These data serve as indicators of fidelity. The Detailed Activity report captures centers' completion of key steps in the improvement process (completion of a self-assessments and creation/completion of action plans). For this study, centers were expected to complete a cycle of the improvement process for Nutrition and one for Physical Activity, including all key steps.

Child nutrition self-assessment scores are captured on the Go NAPSACC website when a center director completed a self-assessment at the start and end of an improvement cycle. Completing self-assessments is an intervention component that may, or may not, be used by centers. Each self-assessment item is rated on a 1-4 point scale, where higher points indicate closer compliance with best practices, with a score of 4 indicating "meets best practice". Scores are then computed as percent of best practices met (range 0 to 100%). Self-assessment data will be extracted using the Go NAPSACC Child Nutrition Self-Assessment Report pulled immediately post-intervention.

Child physical activity self-assessment scores are captured on the Go NAPSACC website when a center completed a self-assessment at the start and end of an improvement cycle. Completing self-assessments is an intervention component that may, or may not, be used by centers. Each self-assessment item is rated on a 1-4 point scale, where higher points indicate closer compliance with best practices, with a score of 4 indicating "meets best practice". Scores are then computed as percent of best practices met (range 0 to 100%). Self-assessment data will be extracted using the Go NAPSACC Child Physical Activity Self-Assessment Report pulled immediately post-intervention.

Mean total EPAO-SR scores (percent best practices met) for centers starting with high or low contextual setting support reported by directors. Director report of contextual support was assessed using baseline surveys. Specifically, Fernandez's consolidated framework for implementation research (CFIR) inner setting measure was used to assess Culture, Culture Stress, Culture Effort, Implementation Climate, Leadership Engagement, Information access, and Available Resources. Scores from theses sub-scales were averaged to create a composite "inner setting" score. To assess the impact of baseline inner setting score and intervention group on nutrition and physical activity environment best practice scores, composite "inner setting" scores were classified as high or low using a median split. This high/low indicator of contextual support was included as interaction term in analysis models (i.e. Time [baseline-followup] * Intervention Group [basic-enhanced] * Context level[high-low]).

Mean total EPAO-SR scores (percent best practices met) for centers starting with high or low contextual setting support reported by staff. Staff report of contextual setting support was assessed using baseline surveys. Specifically, Fernandez's consolidated framework for implementation research (CFIR) inner setting measure was used to assess Culture, Culture Stress, Culture Effort, Implementation Climate, Leadership Engagement, Information access, and Available Resources. Scores from theses sub-scales were averaged to create a composite "inner setting" score. To assess the impact of baseline inner setting score and intervention group on nutrition and physical activity environment best practice scores, composite "inner setting" scores were classified as high or low using a median split. This high/low indicator of contextual support was included as interaction term in analysis models (i.e. Time [baseline-followup] * Intervention Group [basic-enhanced] * Context level[high-low]).

Costs of implementation per center include TA coaches time and any resources required to train and support centers for 12 months. Cost tracking used the TA Activity Log to capture TA coaches' time and a supplemental log of additional costs (e.g., mileage, printing). These data were combined to calculate the average cost per center for implementing Go NAPSACC. Final amounts are expressed as cost (dollar $) per center.

Completion of these Go NAPSACC program components was captured using the TA activity log in Go NAPSACC website and tracking data maintained by the study interventionist and project manager. These data serve as indicators of fidelity. In the TA Activity Log all coaches document their implementation activities for each center they serve. Based on their prescribed implementation model (basic or enhanced), these data were used to calculate the percentage of a TAs centers completing the prescribed implementation activities.

TA coaches in the ENHANCED implementation arm were asked to hold 3 cross-center meeting during the 1 year intervention. These meeting could be online or in-person, but were intended to include directors from all centers the TA coach served. The study interventionist and project manager tracked each meeting. These data were used to calculate the percentage of prescribed implementation activities completed.

TA coaches were asked to log implementation activities and contacts with each center in the TA Activity Log through the Go NAPSACC website. Information for analysis was extracted from the website using the TA Activity Report.

TA coaches were asked to attend trainings with the study interventionist. The study interventionist and project manager tracked attendance at each training session. TA coaches in the BASIC arm were asked to attend three training sessions, while TA coaches in the ENHANCED arm were asked to attend 6 sessions. Based on their prescribed implementation model (basic or enhanced), these data were used to calculate the percentage of prescribed implementation activities completed.

TA coaches were asked to attend group check-ins with the study interventionist. The study interventionist and project manager tracked attendance at each group check-in. TA coaches in the BASIC arm were asked to attend one group check-in, while TA coaches in the ENHANCED arm were asked to attend 12 group check-ins and 3 one-on-one check-ins with study interventionist Based on their prescribed implementation model (basic or enhanced), these data were used to calculate the percentage of prescribed implementation activities completed.

Total of all reporting groups

missing data - participants did not provide sex classification on questionnaire

Each center's physical activity environment was assessed using the Environment and Policy Assessment and Observation- Self Report (EPAO-SR), a self-report measure filled out through online surveys by child care center directors and preschool classroom teachers. In addition, directors upload policy handbooks, which were reviewed by a trained staff member. An overall physical activity environment score was derived with scores ranging from 0-3, where higher scores indicate better (more supportive) physical activity environments.

The unit of analysis for this outcome is center-level physical activity environment score, derived from surveys completed by directors and staff at each center. Survey responses from directors and staff must be combined to compute the physical activity environment score for a center, therefore the number of participants analyzed is the number of centers in each arm, not the total number of directors and staff.

The number of participating centers will be captured by the Go NAPSACC website and extracted using the Go NAPSACC registration report. The registration report documents all child care centers that have completed registration and created a Go NAPSACC account. Creation of an account will be used to define participation/adoption.

Centers recruited and randomized

Number of Go NAPSACC core program components completed was captured by the Go NAPSACC website and extracted using the Detailed Activity Report. These data serve as indicators of fidelity. The Detailed Activity report captures centers' completion of key steps in the improvement process (completion of a self-assessments and creation/completion of action plans). For this study, centers were expected to complete a cycle of the improvement process for Nutrition and one for Physical Activity, including all key steps.

For this outcome only childcare centers that completed registration in the Go NAPSACC website system were analyzed. As presented in outcome #3, 40 of 55 centers from the enhanced arm and 38 of 42 centers in the basic arm created an account in the Go NAPSACC website. These outcomes could only be computed for the 78 centers (40 + 38) with accounts.

Child nutrition self-assessment scores are captured on the Go NAPSACC website when a center director completed a self-assessment at the start and end of an improvement cycle. Completing self-assessments is an intervention component that may, or may not, be used by centers. Each self-assessment item is rated on a 1-4 point scale, where higher points indicate closer compliance with best practices, with a score of 4 indicating "meets best practice". Scores are then computed as percent of best practices met (range 0 to 100%). Self-assessment data will be extracted using the Go NAPSACC Child Nutrition Self-Assessment Report pulled immediately post-intervention.

Only 49 centers (27 + 22) completed the first nutrition self-assessment. Centers without a nutrition self-assessment in the Go NAPSACC website system were not analyzed. At follow-up 13 of 27 centers from Enhanced arm and 7 of 22 centers from basic arm completed the nutrition self-assessment.

Child physical activity self-assessment scores are captured on the Go NAPSACC website when a center completed a self-assessment at the start and end of an improvement cycle. Completing self-assessments is an intervention component that may, or may not, be used by centers. Each self-assessment item is rated on a 1-4 point scale, where higher points indicate closer compliance with best practices, with a score of 4 indicating "meets best practice". Scores are then computed as percent of best practices met (range 0 to 100%). Self-assessment data will be extracted using the Go NAPSACC Child Physical Activity Self-Assessment Report pulled immediately post-intervention.

Only 44 centers (24 + 20) completed the first physical activity self-assessment. Centers without a physical activity self-assessment in the Go NAPSACC website system are not analyzed. At follow-up 10 of 24 centers in the enhanced arm and 4 of 20 centers from the Basic arm completed the physical activity self-assessment.

Mean total EPAO-SR scores (percent best practices met) for centers starting with high or low contextual setting support reported by directors. Director report of contextual support was assessed using baseline surveys. Specifically, Fernandez's consolidated framework for implementation research (CFIR) inner setting measure was used to assess Culture, Culture Stress, Culture Effort, Implementation Climate, Leadership Engagement, Information access, and Available Resources. Scores from theses sub-scales were averaged to create a composite "inner setting" score. To assess the impact of baseline inner setting score and intervention group on nutrition and physical activity environment best practice scores, composite "inner setting" scores were classified as high or low using a median split. This high/low indicator of contextual support was included as interaction term in analysis models (i.e. Time [baseline-followup] * Intervention Group [basic-enhanced] * Context level[high-low]).

The unit of analysis for this outcome is center-level, derived from surveys completed by directors at each center. The sample size is the number of centers randomized to each study arm.

Mean total EPAO-SR scores (percent best practices met) for centers starting with high or low contextual setting support reported by staff. Staff report of contextual setting support was assessed using baseline surveys. Specifically, Fernandez's consolidated framework for implementation research (CFIR) inner setting measure was used to assess Culture, Culture Stress, Culture Effort, Implementation Climate, Leadership Engagement, Information access, and Available Resources. Scores from theses sub-scales were averaged to create a composite "inner setting" score. To assess the impact of baseline inner setting score and intervention group on nutrition and physical activity environment best practice scores, composite "inner setting" scores were classified as high or low using a median split. This high/low indicator of contextual support was included as interaction term in analysis models (i.e. Time [baseline-followup] * Intervention Group [basic-enhanced] * Context level[high-low]).

The unit of analysis for this outcome is center-level, derived from surveys completed by staff at each center. Survey responses from staff are combined to compute the contextual score for a center, therefore the number of participants analyzed is the number of centers in each arm, not the total number of staff.

Costs of implementation per center include TA coaches time and any resources required to train and support centers for 12 months. Cost tracking used the TA Activity Log to capture TA coaches' time and a supplemental log of additional costs (e.g., mileage, printing). These data were combined to calculate the average cost per center for implementing Go NAPSACC. Final amounts are expressed as cost (dollar $) per center.

The sample size is the number of centers randomized to each study arm.

Completion of these Go NAPSACC program components was captured using the TA activity log in Go NAPSACC website and tracking data maintained by the study interventionist and project manager. These data serve as indicators of fidelity. In the TA Activity Log all coaches document their implementation activities for each center they serve. Based on their prescribed implementation model (basic or enhanced), these data were used to calculate the percentage of a TAs centers completing the prescribed implementation activities.

TA coaches was the unit of analysis. For each TA coach, the percent of centers completing each outcome was computed. The TA coaches in the BASIC arm of the intervention did not have their centers: form leadership teams, complete a readiness check, or select priority areas for change. These tasks were only completed by TA coaches using the enhanced delivery model (Enhanced Go NAPSACC arm).

TA coaches in the ENHANCED implementation arm were asked to hold 3 cross-center meeting during the 1 year intervention. These meeting could be online or in-person, but were intended to include directors from all centers the TA coach served. The study interventionist and project manager tracked each meeting. These data were used to calculate the percentage of prescribed implementation activities completed.

Cross center meetings were only completed by TA coaches (n=14) using the enhanced delivery model (Enhanced Go NAPSACC arm). The TA coaches in the BASIC arm of the intervention (n=13) did not conduct cross-center meetings. Therefore the Basic Arm is not included in analysis.

TA coaches were asked to log implementation activities and contacts with each center in the TA Activity Log through the Go NAPSACC website. Information for analysis was extracted from the website using the TA Activity Report.

TA coaches who completed activity logs within Go NAPSACC website were counted as completing activity logs. TA coaches who provided no log of activities were counted as having incomplete logs.

TA coaches were asked to attend trainings with the study interventionist. The study interventionist and project manager tracked attendance at each training session. TA coaches in the BASIC arm were asked to attend three training sessions, while TA coaches in the ENHANCED arm were asked to attend 6 sessions. Based on their prescribed implementation model (basic or enhanced), these data were used to calculate the percentage of prescribed implementation activities completed.

TA coach attendance at trainings was computed and summarized over coaches in each arm.

TA coaches were asked to attend group check-ins with the study interventionist. The study interventionist and project manager tracked attendance at each group check-in. TA coaches in the BASIC arm were asked to attend one group check-in, while TA coaches in the ENHANCED arm were asked to attend 12 group check-ins and 3 one-on-one check-ins with study interventionist Based on their prescribed implementation model (basic or enhanced), these data were used to calculate the percentage of prescribed implementation activities completed.

TA coach check-in attendance was computed then summarized for each study arm.

Go NAPSACC implemented with the Basic delivery model,